Italian Board of Guardians, Inc.

7808 18th Ave.
Brooklyn, Ny 11214

Enclosed is my gift in the amount of $__________.
Please make checks payable to the Italian Board of Guardians, Inc.

My contribution is made:

In Memory of:

Name _______________________________

In Honor of:

Name _______________________________

Donor Name _____________________________________

Donor Address _______________________________________

Donor City, State, Zip ___________________________________________

Please send an acknowledgment scroll of this Gift to:

Name _____________________________

Address _______________________________

City, State, Zip ___________________________________

This gift is eligible for a matching gift from my employer:

________________________________________________________________________

________________________________________________________________________

Employer Name and Address